AbstractObjectives: National Swedish guidelines for treatment with botulinum toxin in children and adolescents with cerebral palsy (CP) include evaluation of self-estimated effects of treatment. We hypothesized that the treatment effect subsides after the first injection.
Methods: Children (or their parents), receiving their first botulinum toxin treatment of upper limb before the age of 20 years, filled in a questionnaire (visual analog scale; VAS) six weeks after each injection.
Results: Eighty-one out of 95 children or adolescents were evaluated (35% girls; 65% boys; 61% unilateral; 34% bilateral; 5% dyskinetic). Patients with unilateral CP were younger (median 8, range 1-19 years) than those with bilateral CP (12.5, 4-19 years; p<0.01). Patients with uni- and bilateral CP showed a sufficient [first injection median 64 (0-100) and 63 (0-100), respectively], and a sustained or better effect after two or three injections. The effect was also noted in patients divided by indication [i.e. prophylaxis contracture; 48 (0-100); improved positioning; 65 (11-100); improve hand function; [64 (0-100)]. Discomfort by the injection had a tendency to decrease after the first injection.
Conclusion: The self-estimated effect of treatment with botulinum toxin treatment is sufficient and does not deteriorate after the first injection in uni- and bilateral CP.